Critical Care HESI Practice Questions and
Answers | Latest 2024-2025 | Critical
Care HESI Test Bank Graded A
This comprehensive guide contains verified questions and answers for the
Critical Care HESI exam, based on 2024-2025 test bank materials. All
answers are graded A and include detailed rationales for effective exam
preparation .
Section 1: Hemodynamics and Shock
Question 1: The nurse is caring for a client with a pulmonary artery
catheter. Which hemodynamic value indicates cardiogenic shock?
● A) Cardiac index (CI) 1.8 L/min/m²
● B) Central venous pressure (CVP) 2 mmHg
● C) Pulmonary artery wedge pressure (PAWP) 8 mmHg
● D) Systemic vascular resistance (SVR) 700 dynes/sec/cm⁻⁵
Correct Answer: A) Cardiac index (CI) 1.8 L/min/m²
Rationale: Normal CI is 2.5-4.0 L/min/m². A CI less than 2.2 indicates
cardiogenic shock with decreased cardiac output. CVP and PAWP are
elevated in cardiogenic shock, not decreased .
Question 2: A client in septic shock has a BP of 70/40 mmHg, HR 130 bpm,
and urine output of 10 mL/hr. The nurse anticipates which order first?
● A) Norepinephrine continuous infusion
● B) 30 mL/kg isotonic crystalloid bolus
, ● C) Blood transfusion of packed red blood cells
● D) Dobutamine continuous infusion
Correct Answer: B) 30 mL/kg isotonic crystalloid bolus
Rationale: The Surviving Sepsis Campaign recommends initial fluid
resuscitation with 30 mL/kg of crystalloids within the first 3 hours of
sepsis-induced hypoperfusion. Vasopressors are added if hypotension
persists after fluid resuscitation .
Question 3: A client with burn injury develops massive edema and
hypotension. The nurse recognizes this as which type of shock?
● A) Cardiogenic shock
● B) Hypovolemic shock
● C) Distributive shock
● D) Obstructive shock
Correct Answer: C) Distributive shock
Rationale: Burn injury causes systemic inflammatory response with
massive capillary leak, leading to distributive shock. Fluid shifts from
intravascular to interstitial space, causing relative hypovolemia and
hypotension despite adequate total body water .
Question 4: Which assessment finding in a client with a pulmonary artery
catheter suggests the client is developing cardiogenic shock?
● A) Cardiac output 8 L/min, SVR 600
● B) PAWP 24 mmHg, CI 1.6 L/min/m²
● C) CVP 2 mmHg, PAWP 6 mmHg
● D) Mixed venous oxygen saturation 75%
Correct Answer: B) PAWP 24 mmHg, CI 1.6 L/min/m²
, Rationale: Cardiogenic shock is characterized by high filling pressures
(PAWP >18 mmHg, CVP >12 mmHg) with low cardiac output (CI <2.2
L/min/m²). The combination of elevated PAWP and decreased CI confirms
cardiogenic shock .
Question 5: A client with neurogenic shock has a BP of 80/50 mmHg and
HR 52 bpm. Which nursing intervention is most appropriate?
● A) Administer atropine
● B) Administer norepinephrine infusion
● C) Administer fluid bolus
● D) All of the above
Correct Answer: D) All of the above
Rationale: Neurogenic shock causes vasodilation and bradycardia due to
loss of sympathetic tone. Treatment includes fluid resuscitation,
vasopressors (norepinephrine), and atropine if bradycardia is severe .
Section 2: Mechanical Ventilation
Question 6: The nurse is caring for a client on mechanical ventilation with
an FiO₂ of 0.8 and PEEP of 10 cm H₂O. The arterial blood gas shows pH
7.38, PaO₂ 55 mmHg, PaCO₂ 42 mmHg, HCO₃ 24 mEq/L. The nurse should
anticipate which order?
● A) Increase FiO₂ to 1.0
● B) Increase PEEP to 15 cm H₂O
● C) Increase respiratory rate
● D) Decrease FiO₂ to 0.6
Correct Answer: B) Increase PEEP to 15 cm H₂O
Answers | Latest 2024-2025 | Critical
Care HESI Test Bank Graded A
This comprehensive guide contains verified questions and answers for the
Critical Care HESI exam, based on 2024-2025 test bank materials. All
answers are graded A and include detailed rationales for effective exam
preparation .
Section 1: Hemodynamics and Shock
Question 1: The nurse is caring for a client with a pulmonary artery
catheter. Which hemodynamic value indicates cardiogenic shock?
● A) Cardiac index (CI) 1.8 L/min/m²
● B) Central venous pressure (CVP) 2 mmHg
● C) Pulmonary artery wedge pressure (PAWP) 8 mmHg
● D) Systemic vascular resistance (SVR) 700 dynes/sec/cm⁻⁵
Correct Answer: A) Cardiac index (CI) 1.8 L/min/m²
Rationale: Normal CI is 2.5-4.0 L/min/m². A CI less than 2.2 indicates
cardiogenic shock with decreased cardiac output. CVP and PAWP are
elevated in cardiogenic shock, not decreased .
Question 2: A client in septic shock has a BP of 70/40 mmHg, HR 130 bpm,
and urine output of 10 mL/hr. The nurse anticipates which order first?
● A) Norepinephrine continuous infusion
● B) 30 mL/kg isotonic crystalloid bolus
, ● C) Blood transfusion of packed red blood cells
● D) Dobutamine continuous infusion
Correct Answer: B) 30 mL/kg isotonic crystalloid bolus
Rationale: The Surviving Sepsis Campaign recommends initial fluid
resuscitation with 30 mL/kg of crystalloids within the first 3 hours of
sepsis-induced hypoperfusion. Vasopressors are added if hypotension
persists after fluid resuscitation .
Question 3: A client with burn injury develops massive edema and
hypotension. The nurse recognizes this as which type of shock?
● A) Cardiogenic shock
● B) Hypovolemic shock
● C) Distributive shock
● D) Obstructive shock
Correct Answer: C) Distributive shock
Rationale: Burn injury causes systemic inflammatory response with
massive capillary leak, leading to distributive shock. Fluid shifts from
intravascular to interstitial space, causing relative hypovolemia and
hypotension despite adequate total body water .
Question 4: Which assessment finding in a client with a pulmonary artery
catheter suggests the client is developing cardiogenic shock?
● A) Cardiac output 8 L/min, SVR 600
● B) PAWP 24 mmHg, CI 1.6 L/min/m²
● C) CVP 2 mmHg, PAWP 6 mmHg
● D) Mixed venous oxygen saturation 75%
Correct Answer: B) PAWP 24 mmHg, CI 1.6 L/min/m²
, Rationale: Cardiogenic shock is characterized by high filling pressures
(PAWP >18 mmHg, CVP >12 mmHg) with low cardiac output (CI <2.2
L/min/m²). The combination of elevated PAWP and decreased CI confirms
cardiogenic shock .
Question 5: A client with neurogenic shock has a BP of 80/50 mmHg and
HR 52 bpm. Which nursing intervention is most appropriate?
● A) Administer atropine
● B) Administer norepinephrine infusion
● C) Administer fluid bolus
● D) All of the above
Correct Answer: D) All of the above
Rationale: Neurogenic shock causes vasodilation and bradycardia due to
loss of sympathetic tone. Treatment includes fluid resuscitation,
vasopressors (norepinephrine), and atropine if bradycardia is severe .
Section 2: Mechanical Ventilation
Question 6: The nurse is caring for a client on mechanical ventilation with
an FiO₂ of 0.8 and PEEP of 10 cm H₂O. The arterial blood gas shows pH
7.38, PaO₂ 55 mmHg, PaCO₂ 42 mmHg, HCO₃ 24 mEq/L. The nurse should
anticipate which order?
● A) Increase FiO₂ to 1.0
● B) Increase PEEP to 15 cm H₂O
● C) Increase respiratory rate
● D) Decrease FiO₂ to 0.6
Correct Answer: B) Increase PEEP to 15 cm H₂O
